Dr Biran on the DREAMM-7 Trial in Multiple Myeloma

Noa Biran, MD, associate professor, medicine, Hackensack Meridian School of Medicine, physician, Division of Multiple Myeloma, John Theurer Cancer Center, Hackensack Meridian Health, discusses the implications of findings from the phase 3 DREAMM-7 trial (NCT04246047) in patients with multiple myeloma, as presented at the 2024 ASCO Annual Meeting.

The DREAMM-7 trial, which also had data read out during the 2024 February ASCO Plenary Series, examined the efficacy of combining belantamab mafodotin-blmf (Blenrep) with bortezomib (Velcade) and dexamethasone vs using the standard-of-care regimen daratumumab (Darzalex), bortezomib, and dexamethasone (DVd) in patients with early relapsed multiple myeloma, Biran begins. This trial’s significance lies in its head-to-head, triplet-to-triplet comparison, which demonstrated a notable improvement in the duration of response with the belantamab mafodotin combination, she explains.

The median progression-free survival (PFS) for patients receiving belantamab mafodotin plus bortezomib and dexamethasone was 36.6 months (95% CI, 28.4–not reached), compared with 13.4 months (95% CI, 11.1-17.5) for those who received the DVd regimen, Biran continues, adding that these results are particularly impactful. This is because belantamab mafodotin was previously removed from the market due to concerns about efficacy and toxicity, she emphasizes. However, the substantial improvement in PFS observed in the DREAMM-7 study could potentially alter the FDA’s stance on belantamab mafodotin, providing strong support for its approval in the early relapsed setting, she elucidates.

Overall, the findings derived from the DREAMM-7 trial indicate that the belantamab mafodotin–based combination may offer a superior treatment option for patients who have early relapsed myeloma, she expands. Notably, this regimen is expected to significantly extend their PFS and may potentially reshape the current treatment protocols, Biran says. This could lead to the reintroduction of belantamab mafodotin into the relapsed multiple myeloma treatment paradigm, offering new hope for patients and clinicians dealing with this challenging stage of myeloma, she concludes.